Healthcare Provider Details

I. General information

NPI: 1164396677
Provider Name (Legal Business Name): ALEXI HILDRETH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7051 HEATHCOTE VILLAGE WAY STE 210
GAINESVILLE VA
20155-3199
US

IV. Provider business mailing address

7051 HEATHCOTE VILLAGE WAY STE 210
GAINESVILLE VA
20155-3199
US

V. Phone/Fax

Practice location:
  • Phone: 571-261-1234
  • Fax: 571-261-2235
Mailing address:
  • Phone: 571-261-1234
  • Fax: 571-261-2235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110011390
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: